Doctors must deliver more bad news to patients, as a worldwide cancer drug shortage hits Nashville

Two of the most common chemotherapy drugs — including the only drug known to cure testicular cancer — are in short supply. It means oncologists are having to ration drugs and tweak treatment plans.

“We’ve been out of carboplatin now for a few days … and now have such a supply of cisplatin that we need to reserve that only for patients with testicular cancer,” said Dr. Stephen Schleicher, the chief medical officer of Tennessee Oncology, which treats half of the state’s cancer patients.

It’s becoming a familiar story: A drug manufacturer either cuts back or goes offline. Then patients struggle to get the medications they need. That’s what happened with the Adderall shortage over the past year, and it’s now happening with chemotherapy.

Schleicher said getting a cancer diagnosis is bad enough in the first place.

“I can’t even imagine being the patient on the other end, who are already going through this scary time,” he said. “We’re trying to be their guide through this journey, and then they have to hear from us, ‘Sorry, we don’t have this drug.'”

Carboplatin and cisplatin are long-established cancer drugs. Schleicher said that although there have been hundreds of new cancer drugs and treatments approved in recent years, many of them are used in conjunction with older chemotherapy drugs, like carboplatin and cisplatin.

“So even though we’ve made a lot of progress, these are still the backbones of many of our treatments,” he said.

Oncologists are turning to disease experts for advice on tweaking treatment plans, says Schleicher.

“This is a short-term problem,” he said. “Short-term — whether that’s several months to many months — but hopefully, this is not the new norm. I think that it’s all hands on deck. How do we find a way to solve this and prevent this from happening again?”

NPR reported that this drug shortage and a dozen others stem from the same problem. There is very little profit margin on manufacturing generic drugs. Inflation and issues tied to the COVID-19 pandemic, such as supply shortages, have made that even worse. That has caused several manufacturers to shutter, and the ones that are left are under heavy strain, which incentivizes cutting corners.

The Associated Press reported that, after an inspection raised quality concerns, one of the main factories responsible for these two drugs recently halted production.

The U.S. Food and Drug Administration announced it will import more cisplatin from China, but that the drug is “marketed and manufactured in China and is not FDA-approved.”